Treatment With Silymarin for Hepatitis C Virus—Reply

Author Affiliations: Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill (Dr Fried; mfried@med.unc.edu); Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, Chapel Hill, North Carolina (Dr Hawke); and Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia (Dr Reddy).

In Reply: The presence of conflicting data regarding the efficacy of silymarin was a prime motivator for conducting detailed phase 1 and phase 2 clinical trials of oral silymarin in a well-characterized population with chronic hepatitis C.1-3 We agree that the reports of intravenous silibinin succinate for HCV are intriguing and deserve further inquiry; however, they are not analogous to studies of the oral formulation.4